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NPI Code Detail

MEDICARE: HADEIAH MELODY HOSSEINI PA-C

MEDICARE:   HADEIAH MELODY HOSSEINI  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1043908866
Entity Type Code : Individual
Provider Name (Legal Business Name) : HADEIAH MELODY HOSSEINI PA-C
Provider Business Mailing Address
First Line : 18200 YORBA LINDA BLVD STE 250
Second Line :
City : YORBA LINDA
State : CA
Zip : 92886-4044
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18200 YORBA LINDA BLVD STE 250
Second Line :
City : YORBA LINDA
State : CA
Zip : 92886-4044
Country : US
Telephone Number : 714-577-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2023
Last Update Date : 04/28/2023

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Directions to “ HADEIAH MELODY HOSSEINI PA-C” Practice Location

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